Heart disease. With no warning!

by Expat Life

Cardiologists at Sukumvit hospital, treating heart disease in patients who have a sudden onset of symptoms.

Khun Kultheep, the patient

Khun Kultheep, a 73 year old Thai-Indian based in India for business would return to Thailand annually for a general health checkup at Sukumvit Hospital. Over time, he became well acquainted with Dr. Davin Narula, former Director of the hospital, who he consulted with when he had any questions about his health or his family’s health. When Covid-19 struck Khun Kultheep was in Thailand and found himself unable to return to India. One day, his wife invited him on a walk but shortly after, he began feeling hot and he lost the desire to continue exercising. The next evening, he felt similar symptoms coupled with a squeezing sensation in his chest. Five minutes later, the pressure disappeared and he was able to walk without anything else occurring. The next day, symptoms returned so he called Dr. Davin who advised him to visit Sukumvit Hospital to determine the cause of the persistent chest pain. At the hospital, he met Dr. Nivit Kalra, a cardiologist at the Cardiac Centre, who used an electrocardiogram (ECG) to monitor his heart rate. 

He then underwent an exercise stress test (EST), and less than a minute in the machine indicated that the heart was receiving insufficient blood. This condition requires catheterisation using a stent to expand the vessels as quickly as possible. Once the procedure was complete, the patient no longer experienced tightness. After a month, he went for a follow up examination and found… “I can lift things and everything is normal. The doctor told me that after 15 days I could return to a life as before. Procedures have evolved, so during the catheterisation I did not feel any pain. I did not think I had heart disease, it was shocking because I experienced no warning signs. The doctors said it was good I received treatment quickly, as waiting would have been dangerous.”

Heart abnormalities mimic gastrointestinal complications: A patient’s history can help provide insight. In the past, Khun Kultheep was in good health, got his health checked regularly, had normal blood pressure, and slightly elevated cholesterol (not to the point where medication was required). The initial reason he visited the hospital was because of some abdominal issue. Dr. Nivit had prepared him for an EST to determine the diagnosis of coronary heart disease rather than gastrointestinal problems. So for the full scope, more tests were done. Cardiac Catheterisation determined that the left anterior descending artery was 90% blocked, requiring intervention. A serious problem as the artery is most responsible for giving the heart blood. Stents were used to expand the vessels, allowing for adequate blood flow to return. It can be difficult to determine the root cause of chest pain because heart attack and heartburn are two conditions with similar symptoms. However, hear attack causes a sensation of tightness, therefore in situations where one cannot explain the cause or symptoms do not improve, seek immediate medical attention. Normally, patients are recommended to stay in hospital for a few days before returning home to rest for one week, Dr. Nivit explains… “To successfully rehabilitate, rest is imperative. But because the catheterisation is done through the arm, patients do not need to refrain from walking. However, it is best to avoid exercise for a week so that they can return to a normal routine as soon as possible.”

Regular checkups are crucial

Dr. Nivit reports that in 2019, the number of heart disease patients increased but mortality rates decreased. Harsh work routines and constant stress have led to people becoming careless with their lifestyles, giving less importance to exercise and good food so disease prevalence has increased. However, because of better technology in medical care, mortality rates are lower. He explains… “Patients need to give more importance to regular checkups and visiting a doctor whenever unusual symptoms arise, so that the cause can be determined and treatment can be administered quickly. Nowadays, treatments are less painful, less invasive, require a short recovery period, and also cost less. Ultimately we want people to have healthy bodies and minds no matter the age. Heart tests have evolved, they can reduce the chance of heart attacks through tests like the EST, which monitors heart rate when the body is subject to physical exertion to see if the heart is receiving enough blood and oxygen. If a patient has risk factors, such as being older than 45, high cholesterol, high blood pressure, diabetes, or a history of smoking, tests can measure calcium deposits in the arteries using a CT Calcium Score. This can be helpful in assessing the likelihood of an angina, which can reduce the chance of a heart attack. Behaviours causing a disease can then be adjusted and care can be given. The aforementioned treatments are all precise and safe.”

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